Angiotensin converting enzyme inhibitors

Inhibitors of the angiotensin converting enzyme (ACE) are frequently employed. In this article, learn about their types, uses and side effects.

High blood pressure, weak heart muscles, and chronic renal failure are all conditions that can be treated with ACE inhibitors.

ACE inhibitors and their mechanism of action

These medications work by blocking the enzyme that converts to angiotensin (angiotensin-converting enzyme). As a result, the blood's concentration of angiotensin II will drop, leading to the widening of blood vessels. Additionally, less aldosterone from the adrenal gland will be secreted, which will result in lower blood pressure and less strain on the heart.

Patients who are younger than adults benefit more from ACE inhibitors, and white patients respond to them better than black patients.

Examples of angiotensin converting enzyme inhibitors

ACE inhibitors come in a variety of forms, and these medicines include:

• benazepril;
• captopril.
• enalapril.
• fosinopril.
•  lisinopril.
• moexipril;
• quinapril.
• Perindopril.
•  ramipril.
•  Trandolapril.

Indications

Angiotensin-inhibiting medications may be prescribed for a number of conditions, including:

• Hypertension.
• Cardiac weakness.
• Coronary artery stenosis.
• Chronic renal failure.
• Diabetics.
• Kidney crisis in patients with scleroderma.

The side effects

While taking ACE inhibitors, users may experience a variety of side effects, including:

• The most common symptoms

1. Dry cough (10-20%).
2. Dizziness (12-19%).
3. Hypotension (7-11%): It usually occurs with the first doses of the drug or in patients with hypovolemia.
4.  Elevated creatinine and blood urea nitrogen (2-11%).
5.  coma (5-7%).
6.  High blood potassium (2-6%): especially in patients who suffer from diseases that may increase the level of potassium in the blood, such as patients with kidney failure, or who use other drugs that may raise potassium levels (eg: spironolactone).

• Less common symptoms

Angioedema: Prolonged fluid leakage from blood vessels beneath the skin, most frequently in the face (particularly the lips). Although it is uncommon, it could endanger the patient's life because the fluid buildup around the airway could result in shortness of breath or suffocation. It usually occurs in patients with dark skin or those with hereditary angioedema.

1.  Anaphylaxis reaction.
2. Loss of sense of taste.
3. Headache.
4. Tachycardia.
5. pain in chest.
6. Acute renal failure: It may occur in patients with narrowing of the renal arteries, which leads to a sudden rise in kidney function (BUN & creatinine).

Contraindications

The use of ACE inhibitors is either not advised or contraindicated in a number of situations, such as:

• Pregnant women are not permitted to receive these medications because they are among the substances that have been linked to foetal deformities.
• if the patient has an allergy to these valleys or any of their elements.
• If the patient has hereditary angioedema or has experienced this condition in the past
• Acute renal failure is more likely to occur if the patient is also taking aliskiren when these two medications are taken together.
• Because sacubitril increases the risk of angioedema, if the patient is taking it.
• The use of ACE inhibitors in patients with bilateral renal artery stenosis may result in acute renal failure, increased blood potassium levels, and impaired renal function.
• These drugs may suddenly lower blood pressure in patients with aortic valve stenosis.

Drug interactions

The following medications are among those that may have an impact on how well ACE inhibitors work:

• NSAIDs: These medications have the potential to lessen the effectiveness of ACE inhibitors.
• Other blood pressure medications: May lead to hypotension.
• Allopurinol: increases the chance of an immune reaction.
• Diuretics that conserve potassium: May raise the blood's potassium levels.